PORT-AU-PRINCE, Haiti — The Caribbean death toll from Hurricane Sandy rose again sharply on Saturday, even as the storm swirled away toward the U.S. East Coast. Officials said the hurricane system has cost at least 58 lives in addition to destroying or badly damaging thousands of homes.

While Jamaica, Cuba and the Bahamas took direct hits from the storm, the majority of deaths and most extensive damage was in impoverished Haiti, where it has rained almost non-stop since Tuesday.

The official death toll in Haiti stood at 44 Saturday, but authorities said that could still rise. The country's ramshackle housing and denuded hillsides are especially vulnerable to flooding when rains come.

"This is a disaster of major proportions," Prime Minister Laurent Lamothe told The Associated Press. "The whole south is under water."

He said the death toll jumped on Saturday because it was the first day that authorities were able to go out and assess the damage, which he estimated was in the hundreds of millions of dollars, the bulk of it in lost crops.

Nineteen people are reported injured and another 12 are missing, according to Haiti's Civil Protection Office.

One of the remaining threats was a still-rising muddy river in the northern part of the capital, Port-au-Prince.

"If the river busts its banks, it's going to create a lot of problems. It might kill a lot of people," said 51-year-old Seroine Pierre. "If death comes, we'll accept it. We're suffering, we're hungry, and we're just going to die hungry."

Officials reported flooding across Haiti, where 370,000 people are still living in flimsy shelters as a result of the devastating 2010 earthquake. Nearly 17,800 people had to move to 131 temporary shelters, the Civil Protection Office said.

Among those hoping for a dry place to stay was 35-year-old Iliodor Derisma in Port-au-Prince, who said the storm had caused a lot of anguish.

"It's wet all my clothes, and all the children aren't living well," he said. "We're hungry. We haven't received any food. If we had a shelter, that would be nice."

Santos Alexis, mayor of the southern city of Leogane, said Saturday that two people were reported dead there, including a man in his late 30s and a boy around 10 years old who drowned. He said the city was hit by heavy rains but that no major damage was reported.

"Water came into the houses, water got on the beds, but they didn't lose their homes," he said. "Leogane was underwater mostly, but now we have less water."

President Michel Martelly and Lamothe handed out water bottles to dozens of people in a Port-au-Prince neighborhood on Friday. They also distributed money to local officials to help clean up the damage.

Sandy left dozens of families homeless when it barreled across Jamaica Wednesday as a Category 1 hurricane. One man was crushed to death by a boulder that tumbled into his house. Military officials on Saturday were carrying supplies and doctors to five communities in the southern mountainous region that had been cut off by floods.

The storm hit eastern Cuba as a Category 2 hurricane early Thursday. Eleven people died in Santiago and Guantanamo provinces and official news media said the storm caused 5,000 houses to at least partially collapse while 30,000 others lost roofs. Banana, coffee, bean and sugar crops were damaged.

The storm then churned into the Bahamas archipelago, toppling light posts, flooding roads and ripping down tree branches. Police said the British CEO of an investment bank died when he fell from his roof in upscale Lyford Cay late Thursday while trying to repair a window shutter. Officials at Deltec Bank & Trust identified him as Timothy Fraser-Smith, who became CEO in 2000.

In Puerto Rico, police said a man in his 50s died Friday in the southern town of Juana Diaz, swept away in a river swollen by rain from Sandy's outer bands. Flooding forced at least 100 families in southwestern Puerto Rico to seek shelter.

Authorities in the Dominican Republic evacuated more than 18,100 people after the storm destroyed several bridges and isolated at least 130 communities. Heavy rains and wind also damaged an estimated 3,500 homes.